Kristina Mauer (WHO)

1. 1

3. Current Percentage of Adult Smokers
within
the WHO European Region

4. Female to Male (Adult)ratio
Africa 3:20 Americas 11:25
Southeast Asia 8:41 Europe 22:40
Mediterranean 5:34
Austria, Denmark,
Ireland, Sweden, Norwa
Western Pacific 14:43
y,
Netherlands and United
Kingdom
4

5. Youth Prevalence of Tobacco
•The WHO European Region has the highest prevalence of youth tobacco
smoking among all the WHO Regions
•The prevalence of female youth is considerably higher in the WHO European
Region than all other WHO Regions
4

6. Tobacco use is the leading cause of
preventable death worldwide
Tobacco Kills nearly 5.4 million people globally
each year... approximately every 6.5 seconds a
person dies due to smoking related diseases
By 2030 tobacco will kill more than 8 million
people worldwide each year
Tobacco is the only product that kills 50% of its
users when used exactly as intended. It is
estimated that if no serious action is taken, up
to 1 billion people could die from tobacco use
in the 21st century

8. Mortality from Tobacco
Compared to the rest of the world, the WHO
European Region has one of the highest
proportions of deaths attributable to tobacco
16% of all deaths in adults over 30 in the WHO
European Region were due to tobacco
This is in contrast to the African or the Eastern
Mediterranean Regions, with 3% and 7%
proportion of tobacco-attributable
deaths, respectively
Global average is 12%
7

9. Voluntary global target for 2025
30% relative reduction in
prevalence of current
tobacco smoking
9

10. 8

11. 176 countries plus the European
Commission so far (almost 90% of
the world’s population) have already
agreed to implement this
international legally binding treaty
9

12. How Europe is doing in tobacco control?
Compared to other Regions, WHO European Region is
doing relatively well. Between 2008 and 2010……
• Region has the highest average cigarette prices and the
highest average tax rates - strong progress since 2008
• Region has the second highest share of Parties that have
introduced a comprehensive ban on tobacco
advertising, promotion and sponsorship BUT progress is weak
since 2008
• Region has the highest level of full protection from tobacco
smoke in indoor workplaces, good progress since 2008
• Majority of Parties with well-established programs in the
treatment of tobacco dependence and cessation come from the
10
Region, no major progress since 2008

13. BUT
• Region has the highest adult and youth smoking
prevalence
•Region has the lowest rates for implementation of large
warnings (more than 50% of main surface of packages)
and also has the lowest share of pictorial warnings
• National tobacco control programmes – elaboration and
implementation is at low level
• Mass media campaigns are rare
11

14. Protecting People from Tobacco Smoke
(WHO FCTC Article 8)
•8
countries, Albania, Hungary, Ireland, Malta, Spain, Turkey, Turkmenistan, United
Kingdom, and now also Ukraine, are smoke-free however level of enforcement
varies greatly
• Educational and healthcare facilities are the public places most likely to be
legislated as smoke-free
• 89% of member countries have national laws requiring fines for violations of
smoke-free laws
• 11 countries had national laws dedicating funds for enforcement
• 24 of the 53 countries in the region (45%) had a complaint driven system 12

15. Percentages of Smoke Free Public Places
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16. What do we know?
• Research clearly shows
that there is no safe level of
exposure to second-hand
smoke
• Comprehensive smoke free
laws are the only effective
means of eliminating the
risks associated with
smoking
• Ventilation and smoking
rooms are not effective
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17. What is the regional evidence on
comprehensive smoke-free policies?
• Strong support from general public
• Strong public support leads to high enforcement
and compliance
• Protect employees by reducing the exposure to
second-hand tobacco smoke in workplaces and
public places
• Protect employees by reducing the content of
second-hand smoke in the air in workplaces and
public places
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18. What is the evidence? (cont.)
• Can cause a decrease in smoking prevalence and
smoking related behaviors
• Can reduce mortality and morbidity from exposure to
second-hand tobacco smoke
• Have a positive impact on economic gains in the
health system
• Do not result in any economic loss and tobacco tax
revenues can be maintained or even increased
• Have either a neutral or positive economic impact on
businesses
• Do not drive away tourism
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19. Important to keep in mind
• All countries are at different starting points
and need to consider the best timing for
implementing comprehensive smoke free
policies
• There still exists great variation in the smoke
free legislation within the Region, starting
from the definitions of indoor
workplaces, indoor public places and public
transport
• There is also great variance in dealing with
compliance, such as the amount of penalties
and whether it is merely symbolic payment or
a substantial amount of money and a strong
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deterrent

20. Raise Taxes on Tobacco (WHO FCTC Article 6)
• 42% of countries within the region report that >75% of the retail price of the
most popular brand of cigarettes is tax
• Prices of the most sold brand of cigarettes (20-pack) in international dollars
range from $1.03 (Kazakhstan) to $9.51 (Ireland)
•Large disparities in price between some neighbouring countries - an
example, cheapest brand in Romania is 4.44 international dollars, while in
neighbouring Moldova, it is 24 cents
• The average % of retail price of the most sold brand of cigarettes that is tax
in high-income countries is 75%, compared to only 51% in low- to middle-
income countries
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21. Tax Percentage of Most Popular Cigarette Brands
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22. Warning about the Dangers of Tobacco
(WHO FCTC Articles 11 and 12)
• No countries within the region fall in the highest implementation category
for cigarette warning label legislation
• 25% of countries in the region have pictorial warnings for cigarettes - an
improvement from the 13% in 2008
• 9% of countries in the region have pictorial warnings for smokeless
tobacco
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23. Percentages of Health Warnings
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24. Enforce Bans on Tobacco
Advertising, Promotion and Sponsorship
(WHO FCTC Article 13)
• 57% of the countries in the region have legislated bans on tobacco
sponsored events
• 25% of the countries in the region have legislated bans on promotional
display at the point of sale - we fall behind most other WHO Regions in ban
on point of sale
• 19% of the countries in the region have legislated bans on tobacco products
in TV/films
• 55% of the countries in the region have legislated bans on tobacco brands
in TV/films
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25. Percentages of Bans on Advertisement
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26. Offering Help to Quit Tobacco Use
(WHO FCTC Article 14)
• 66% of the countries in the region offer nicotine replacement therapies
(NRT) and/or some cessation services, at least one of which is cost covered
• 62% of the countries in the region offer a quit line/help line with a live
person available to discuss cessation with callers
• 8 % of the countries in the region (or 4 countries) offer at least one of
NRT, Bupropion, or Varenicline, with full cost coverage
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27. Percentages of Cessation Service
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28. Monitoring
(WHO FCTC Article 21)
• 62% of countries collect recent, representative and periodic
tobacco control data for adults and youth
• 5 countries carried out GATS and Kazakhstan in 2013
• 29 of 53 countries implemented Global Youth Tobacco Survey
• Only 25% of countries in the Region collect data on smokeless
tobacco use
(Denmark, Finland, Georgia, Iceland, Kyrgyzstan, Latvia, Norwa
y, Poland, Russian Federation, Sweden, Switzerland, Ukraine
and Uzbekistan).
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29. The Power of Data to Fight Tobacco
WHO European Parties to WHO FCTC reported major constraints: 1) lack of
financial aid and/or human resources, 2) industry interference, 3) lack of
political will and 4) need for strengthened inter-sectoral collaboration
Data can…..
Optimize lack of resources…by identifying priority areas for action
Increase political will by…highlighting the problem
Increase political will by…showing public support for introducing new
measure(s)
Tackle industry lobbying by…presenting data to refute their claims
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32. What Does the
Tobacco Industry Do?
• Exaggerating the economic importance of the
industry
• Manipulating public opinion to gain the appearance
of respectability
• Conspiring to influence political and legislative
decisions
• Faking support through front groups
• Discrediting proven science
• Intimidating governments with litigation or the threat
of litigation

34. A total of 176 countries plus the European Commission(almost 90% of the
world’s population) have already agreed to implement an international
treaty, the WHO FCTC and its Article 5.3 and guidelines
Principle 1: There is a fundamental and irreconcilable conflict between the
tobacco industry’s interests and public health policy interests.
Principle 2: Parties, when dealing with the tobacco industry or those working
to further its interests, should be accountable and transparent.
Principle 3: Parties should require the tobacco industry and those working to
further its interests to operate and act in a manner that is accountable and
transparent.
Principle 4: Because their products are lethal, the tobacco industry should not
be granted incentives to establish or run their businesses.
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35. “We know that tobacco use is not
a choice. It is a powerful
addiction. The true choice is
between tobacco and health”
Director General of WHO at World Conference in Singapore.